The procedure identified disorders for which medical therapy was effective in 67% of children. Chronic abdominal pain is the most common indication for EGD in children. However, little is known about the accuracy of EGD-based diagnosis or the outcomes of the patients who undergo this procedure. In a prospective study, Kalpesh Thakkar et al. examined the diagnostic yield of EGD and short-term outcomes of 290 children who underwent this procedure for chronic abdominal pain.

The authors noted that esophagitis was the most common abnormal finding (26%) in children with chronic abdominal pain. Several studies in children confirm that abdominal pain is a frequent presenting symptom of gastroesophageal reflux disease (GERD). Most of the patients in the study of Thakkar et al. (68%) attempted treatment with proton pump inhibitors before EGD, but the presence or response to this therapy did not identify children with esophagitis or GERD.

Thakkar et al. therefore do not recommend proton pump inhibitor therapy before EGD, because the treatment was not associated with a higher diagnostic yield, and most of the children studied (79%) did not have reflux esophagitis.

Further, controlled studies are therefore required to investigate the long-term outcomes of children with chronic abdominal pain who undergo endoscopy.

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About the Author

Dr. Kristine Novak is the science editor for Gastroenterology and Clinical Gastroenterology and Hepatology. She has worked as an editor at biomedical research journals and as a science writer for 15 years, covering advances in gastroenterology, hepatology, cancer, immunology, biotechnology, molecular genetics, and clinical trials. She has a PhD in cell biology and an interest in all areas of medical research.